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September 1972

Hypergastrinemia and the Zollinger-Ellison Syndrome

Arch Surg. 1972;105(3):531. doi:10.1001/archsurg.1972.04180090126031

To the Editor.  —Because of the wellrecognized pitfalls inherent in overdependence upon various demonstrations of gastric hypersecretion, adaptation of radioimmunoassay techniques to the quantization of serum gastrin levels has been readily accepted as another means of diagnostic screening in patients with historical features and secretory studies suggestive of the Zollinger-Ellison syndrome.Quantitative determination of serum gastrin levels has previously been limited to medical centers or private laboratories with radioimmunoassay capabilities. However, several pharmaceutical concerns are presently developing a "test kit" for gastrin determination, which will become available in the immediate future. Just as the autoanalysis of serum calcium levels has exposed the condition of asymptomatic hyperparathyroidism, with more widespread availability of gastrin determinations, an increasing number of patients with hypergastrinemia will be encountered.How will these patients be managed? Should hypergastrinemia per se be regarded as sufficient indication for exploration, or for total gastrectomy if a definitive tissue diagnosis cannot

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